I like that you count their power in souls, a little like landowners in feudal Russia trading in dead souls. Back to the point, I think the purchasing power of

I like that you count their power in souls, a little like landowners in feudal Russia trading in dead souls. Back to the point, I think the purchasing power of a state entity combined with its control over the market is a powerful combination, but also the dysfunctional US market seems to reward healthcare insurers for paying more - they don't care after all if they get ever more money from the poor suckers who have to pay for insurance, they can take a larger cut of a larger pie. I'm not saying insurance markets can't work (someone cited Switzerland above), just that the current US insurance market is out of control and needs solutions (like Obama's solution which has now been wrecked, or single payer which works well elsewhere). What the US has currently doesn't work, fails to serve much of the population, and even then is much more expensive than equivalent services elsewhere.